Resting Energy Research Articles

Resting and total energy expenditure of patients with long-chain fatty acid oxidation disorders (LC-FAODs)

Resting and total energy expenditure of patients with long-chain fatty acid oxidation disorders (LC-FAODs)

Effects of dietary protein-load and alkaline supplementation on acid-base balance and glucose metabolism in healthy elderly.

Metabolism is controlled by macro- and micronutrients. Protein-rich diets should lead to latent acidosis at tissue level with further negative implications. Food supplements with alkaline salts are available and popular pretending to prevent these changes. Within a randomised double-blind placebo-controlled trial we tested the hypotheses that (1) a 4-week protein-rich diet induces a latent tissue acidosis and (2) an alkaline supplement can compensate this. Acid-base balance and important metabolic parameters were determined before and after 4 weeks of supplementation by peripheral blood samples, indirect calorimetry and muscle microdialysis before and after a protein-rich test meal. Fourty volunteers were randomised 1:1 to either verum or placebo supplements. Protein-rich diet by itself did not significantly affect acid-base balance. Alkaline supplementation increased plasma bicarbonate concentration without changing pH. Postprandial increases in serum glucose and insulin tended to be lower for verum vs. placebo. Resting and postprandial energy metabolism, and carbohydrate and fat oxidation did not differ significantly before and after supplementation in both groups. In muscle, postprandial glucose uptake and aerobic glucose oxidation were significantly higher for verum. In addition, verum significantly increased serum magnesium concentrations. Four weeks of protein-rich diet did not significantly influence acid-base balance. However, alkaline supplementation improved systemic and tissue acid-base parameters and oxidative glucose metabolism.

Consistency of indirect calorimetry and HB coefficient method for measuring energy expenditure of patients with sepsis

Objective To evaluate the difference and correlation of 24 h energy expenditure in patients with sepsis by indirect calorimetry (IC) and HB coefficient equation. Methods A prospective comparative study including 60 patients with sepsis who was suitable for nutritional support and respiratory indirect calorimetry in the intensive care unit (ICU) from January to October 2015 was conducted. Resting energy expenditure (REE) was measured simultaneously by respiratory indirect calorimetry and HB coefficient (Harris-Benedict formula×stress coefficient) in 60 patients with sepsis at 0 day, 3 day, 7 day, and 14 day after nutritional support, and the differences in dynamic REE were compared between the two methods. The consistency of REE by indirect calorimetry (IC) and HB coefficient equation was evaluated by Bland-Altman. The correlation of IC and HB methods was determined by Pearson analysis. The linear regression equation was determined by linear regression analysis. Results Within 2 weeks after nutritional support, 188 times of measures by IC method and HB method respectively were finished in all patients with sepsis. The dynamic REE in respiratory indirect calorimetry group was significantly higher than that in HB coefficient method group (P<0.05). The average bias of REE between the IC method and the HB method was (1 930.9±597.7)kJ/24 h. For the consistency boundaries was over large and beyond the scope of clinical acceptance, there was a bias between the two methods and they could not directly substituted. There was a linear correlation of REE between the IC method and the HB coefficient (r=0.757, P=0.000). The equation associated with the HB coefficient method is fitted using a one-way regression: Y=1.17X+ 834.11 (kJ/24 h), and X was the 24 h energy expenditure measured by the HB coefficient method. Conclusion The energy metabolism of patients with sepsis is not obvious in the first 2 weeks. The HB coefficient method significantly underestimates the 24 h energy expenditure of patients with sepsis. The prediction equation can be used to correct the HB coefficient method and improve the HB coefficient method to predict the energy expenditure of patients with sepsis. Key words: Sepsis; Energy Consumption; HB coefficient; Respiratory indirect calorimetry; Correction formula

Energy balance and prognosis of children with mechanical ventilation in pediatric intensive care unit

Objective To investigate the influencing factors for energy balance and the relationship between energy balance and clinical outcome in PICU mechanical ventilation children. Methods Children with mechanical ventilation who were hospitalized in PICU for more than 3 days from June 2015 to May 2016 were collected, resting energy expenditure was measured by resting energy metabolic detector, and the nutrition balance was calculated, the influencing factors on energy balance was analyzed by regression analysis. Results A total of 104 mechanical ventilation children were included with the average energy consumption of (265.4±63.2)kJ/kg in the first 3 days and the average energy supply of (219.8±82.9)kJ/kg, and failed to reach the target value (P<0.05). As the time of hospitalization was prolonged, the supply of energy increased gradually, the SAPS Ⅱ (r=-0.609, P=0.000), mechanical ventilation time (r=-0.456, P=0.000), ICU stay time (r=-0.646, P=0.000), the number of organ failure(r=-0.568, P=0.000), infection complications (r=-0.859, P=0.000) were negatively correlated to energy supply balance; regression analysis showed that complications of nosocomial infection (P=0.000), number of organ failure (P=0.000), mechanical ventilation time (P=0.000), ICU retention time (P=0.001) were predictors of energy supply balance. Conclusion Insufficient supply of energy for the first three days of mechanical ventilation is high in the critically ill children. Factors affecting energy supply balance include patient's organ failure, infection complications, mechanical ventilation time, and ICU retention time, which suggest that the strengthening of the nutritional management of the critically ill children with mechanical ventilation will benefit to the clinical outcome. Key words: Nutritional risk; Resting energy; Mechanical ventilation; Energy balance

Analysis of nutritional status and influence factors in PICU children with mechanical ventilation

Objective To investigate the nutritional status of children with mechanical ventilation, explore the influencing factors of nutritional status, and provide a basis for clinical nutrition support for children with mechanical ventilation. Methods The children with mechanical ventilation who had ventilated for more than 5 days during the period from February 1, 2017 to October 31, 2017 were selected as subjects.According to the mechanical ventilation time, they were divided into group A (5-16 d) and group B(17-29 d). We assessed malnutrition, screened nutritional risk, and measured albumin both on the admission and withdrawal of the ventilator, respectively.We also calculated the average caloric intake value (EI) and fluid volume during mechanical ventilation.Measured resting energy expenditure (MREE)was calculated by using the Schofield-HTWT formula.Feeding status during mechanical ventilation was assessed by average EI/MREE. Results The incidence of malnutrition at admission was 36.1%(13/36), and the incidence of malnutrition was 55.6%(20/36) when evacuated from the ventilator.There was a significant difference(P<0.05). The incidence of malnutrition was similar in group A and group B on admission, but the incidence of malnutrition in group B(62.5%) was significantly higher than that in group A (53.6%) when weaning.The average calorie in group B[(32.25±7.36)kcal/(kg·d)]was significantly lower than that in group A[(40.11±6.00)kcal/(kg·d)]. The mechanical ventilation time of group B[(540.63±89.66)h]was significantly longer than that of group A[(224.46±64.06)h](P<0.05). Conclusion Children with mechanical ventilation in the PICU have a higher incidence of malnutrition and the nutritional status deteriorates further during hospitalization, which may be related to calorie supply, duration of mechanical ventilation, fluid volume, and primary disease. Key words: Mechanical ventilation; Nutritional status; Malnutrition assessment; Nutritional risk screening

An assessment of nutritional status in children on maintenance hemodialysis due to stage 5 chronic kidney disease

To investigate the nutritional status of children on maintenance hemodialysis due to stage 5 chronic kidney disease (CKD) and the clinical significance of nutritional assessment indices. A total of 21 children on maintenance hemodialysis due to stage 5 CKD were grouped according to body mass index. The nutritional status was assessed based on anthropometric parameters, biochemical parameters, inflammatory factors, residual renal function, indices of dialysis adequacy, and resting energy expenditure. Related indices were compared between the children with malnutrition and those with normal nutritional status. Of the 21 children, 10 had malnutrition and 11 had normal nutritional status. There were significant differences between the two groups in anthropometric parameters, levels of leptin, insulin-like growth factor-1, interleukin-1, interleukin-6, and tumor necrosis factor-α, and mean 24-hour residual urine volume (P<0.05), while there were no significant differences in albumin, prealbumin, CONCLUSIONS: urea clearance index (Kt/V), and measured resting energy expenditure. Anthropometric parameters, biochemical parameters, residual renal function, and inflammatory factors have an important value in evaluating the nutritional status of children with stage 5 CKD on maintenance hemodialysis. Further studies are needed to investigate the value of the measurement of resting energy expenditure in the evaluation and monitoring of nutritional status in children with stage 5 CKD on maintenance hemodialysis.

Erratum: Resting and Exercise Energy Metabolism After Liver Transplantation for Nonalcoholic Steatohepatitis: Erratum.

[This corrects the article DOI: 10.1097/TXD.0000000000000701.].

Relationship between resting energy expenditure and metabolic disorders in Chinese obese children and adolescents

Objective To study the characteristics of resting energy expenditure (REE) and evaluate the association between REE and obesity-related comorbidities in obese children and adolescents. Methods Recruited obese children and adolescents were recruited from the Department of Child Health Care in Nanjing Children′s Hospital from July, 2015 to September, 2016.Height, weight(WT), waist circumference, hip circumference, blood pressure were measured.Puberty status was determined by Tanner staging.REE was measured by indirect calorimetry.Body composition, including fat mass (FM), fat free mass (FFM) were assessed in terms of bioelectrical impedance.Serum bioche-mical parameters were assessed, including fasting blood glucose (FBG), fasting blood insulin(FBI), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and uric acid (UA). B-model ultrasono-graphy of the liver was conducted. Results One hundred and ninety-six obese children (143 boys and 53 girls) aged 7-15 years were recruited.The measured REE was (1 497.2±312.1) kcal/d.Pearson correlation analysis indicated that REE was positively related to age(r=0.386, P<0.001), WT(r=0.676, P<0.001), FM(r=0.629, P<0.001), FFM(r=0.635, P<0.001) and FM%(r=0.335, P<0.001), but negatively related to FFM%(r=-0.335, P<0.001). By studying stepwise linear regression, it was found that the factors which influenced REE were age and weight[REE(kcal/d)=899.469-32.098×age(year)+ 16.143×weight (kg), P<0.001]. REE was expressed per kg of body weight (REE/WT), and there was a significant difference in REE/WT during pubertal deve-lopment (P<0.001) in both males and females and the pubertal males had lower REE/WT than females.Moreover, REE/WT was lower in insulin resistant group compared to the normal insulin group.Meanwhile, REE/WT in hypertension group was lower than that in the normal blood pressure group.The above differences remained after adjusted for age adjustment(P<0.01). Conclusion The decrease in REE/WT level in obese children and adolescents is correlated with puberty development and obesity complicated with insulin resistance and hypertension. Key words: Resting energy expenditure; Obesity; Puberty; Obesity-related comorbidities

Measurements of resting energy expenditure in surgical critically ill patients with mechanical ventilator

Objective To compare the differences between measured resting energy expenditure calculated by the indirect calorimetry with the resting energy expenditure calculated by the Harris-Benedict formula and weight formula in the mechanically ventilated surgical critically ill patients in SICU. Methods Patients mechanically ventilated in SICU of Xuanwu Hospital, from April 2014 to April 2015 were measured resting energy expenditure by the indirect calorimetry with the resting energy expenditure calculated by the Harris-Benedict formula and weight formula in the 1st, the 3rd and the 5th day. There were twenty-nine patients enrolled, thirteen males and sixteen females, measured the resting energy expenditure 188 times.The distribution of metabolism level was studied, and the resting energy expenditure measured by three methods were calculated and evaluated by paired sample t test. Results There were 177 times(62.24%)of low metabolism level, 59 times(31.38%)of normal metabolism level, and 12 times(6.38%)of high metabolism level. Eighteen patients used these three methods to calculate the energy expenditure on 1st, 3rd and 5th day: indirect calorimetry (1 627.11±323.63) kcal, (1 614.67±308.93) kcal, (1 576.11±263.96) kcal; Weight formula (1 479.44±200.24) kcal, (1 488.40±227.72) kcal, (1434.14±216.56) kcal; Harris-Benedict formula (1 777.43±253.00) kcal, (1 730.08±265.18) kcal, (1 689.33±236.69) kcal.The results calculated from Harris-Benedict formula and the weight formula were significantly different from calculated from indirect calorimetry(P<0.05). Resting energy expenditure by Harris-Benedict formula was significantly higher than calculated from indirect calorimetry (All P<0.05). Resting energy expenditure by weight formula was significantly lower than calculated from indirect calorimetry(All P<0.05). Conclusions Although Harris-Benedict formula and weight formula is convenient in clinical use, while the results calculated by them is significant different from the results calculated by indirect calorimetry. So clinical nutrition support should rely on indirect calorimetry as far as possible. Key words: Energy metabolism; Nutritional support; Indirect calorimetry; Harris-Benedict formula; Ventilators, mechanical

Era of enhanced recovery after surgery and robotic gastric cancer surgery

Enhanced recovery after surgery (ERAS) has been rapidly developing by combining several techniques with evidence-based adjustments, including preoperative education, preoperative carbohydrate loading, epidural or regional anesthesia, early initiation of enteral nutrition, ambulation and multi-modal pain management. The core part of ERAS is to reduce and reverse surgical stress and therefore greatly improve clinical outcome. Under the guidance of ERAS, perioperative management of robotic gastric cancer operation should follow the basic principles of ERAS and clinical pathway to maximize the advantages of the robotic surgery. ERAS protocol is safe and feasible for patients undergoing robotic radical gastrectomy and it can reduce surgical stress, shorten hospital stay, improve quality of life and does not increase complications, whose mechanism may be associated with the reduction of inflammation and insulin resistance, the decrease of resting energy exposure, and the protection of mitochondria function. It is worth emphasizing that it is very important to fully understand the changes of pathophysiology during perioperative period, to strictly implement the ERAS pathway based on optimized evidence-based medicine, to cooperate closely with the multidisciplinary team, to observe and manage the postoperative complications dynamically by systemic classification. The improvement of ERAS program on the outcome of patients should be summarized regularly and the new interventional strategies should be evaluated further according to the international standard.

Postoperative resting energy expenditure in children with congenital heart disease

Objective To determine postoperative resting energy expenditure (REE) in children with congenital heart disease (CHD) requiring open heart surgery, to compare measured resting energy expenditure(MREE) with current predictive equations (PEE), and to investigate the possible influencing factors on the metabolic status of the postoperative CHD children. Methods From February 2015 to June 2015, 150 ventilated children admitted to the cardiac intensive care unit after surgery for congenital heart disease in Shanghai Children's Medical Center were enrolled consecutively. Indirect calorimetry (IC) measurements were performed using metabolic cart 4 hours after surgery. General clinical data were recorded. Results Totally 104 male and 46 female patients were enrolled, with a median age of 14 months (8.3-36.0 months). The non-protein respiratory quotient of patient was 0.79±0.20, MREE was (264.76±61.74)kJ/(kg·d), and PEE using Schofield equations was (278.51±93.42)kJ/(kg·d). Although there was no significant differences (P=0.096) between MREE and PEE, the agreement was poor between them (R2=0.119). Multivariate stepwise regression analysis showed that MREE had significant positive correlation with risk adjustment in congenital heart surgery(RACHS-1) score(P=0.012) and negative correlation with age (P=0.010). Up to 97.33% of children(146/150) had lower energy intake compared with MREE on the 1st postoperative day. Conclusions MREE does not increase after surgery in CHD children; however, the substrate utilization is influenced. Factors influencing the postoperative REE include RACHS-1 score and age. The energy intake at 1st day after surgery is generally lower than REE in these children. Key words: Children; Congenital heart disease; Resting energy expenditure; Indirect calorimetry

Energy expenditure and nutritional practices in mechanically ventilated children

Objective To identify metabolism and feeding patterns by measurement of resting energy expenditure(MREE) in mechanically ventilated children, and examine the metabolic response in relation to clinical characteristics. Methods Thirty-seven children who fulfilled the criteria for indirect calorimetry were enrolled in this prospective observational study.MREE were obtained on days 1, 4, 7, 10, 14, 21, respectively.Patients were classified as hypometabolic, normal metabolic, and hypermetabolic when MREE were 110% of the predicted resting energy expenditure calculated by Schofield-HTWT equation, respectively.Actual energy intake was recorded, energy intake was classified as underfeeding( 110%). Results On the first day of mechanical ventilation, 40.5% of all children were hypometabolic, 24.3% normal metabolic, and 35.1% hypermetabolic.Only after 7 days, the hypermetabolic pattern dominated(46.7%). Eighty-two measurements were performed in 30 patients(81.1%), who received nutrition support.The mean energy intake was(33.4±22.2) kcal/(kg·d). This was significantly lower than mean MREE, which was(53.7±17.4) kcal/(kg·d)(P<0.01). Underfeeding, adequate feeding, and overfeeding occurred on 75.6%, 9.8%, and 14.6%, respectively. Conclusion The energy metabolism varies widely in mechanically ventilated children during hospitalization.Nearly 90% of the duration in PICU are underfeeding or overfeeding. Key words: Mechanically ventilated children; Indirect calorimetry; Energy expenditure; Feeding patterns,

Characteristics of energy metabolism in patients with acute liver failure and subacute liver failure

Objective To study the characteristics of energy metabolism in patients with acute liver failure (ALF) and subacute liver failure (SALF). Methods Thirteen ALF patients, 23 SALF patients, 20 cases of liver cirrhosis (LC) caused by hepatitis B virus admitted to Beijing Youan Hospital affiliated to Capital Medical University from March 2008 to December 2014, as well as 30 healthy controls (HC) were included in this study. Energy metabolism indexes were measured, including resting energy expenditure (REE), predict resting energy expenditure (pREE), respiratory quotient (RQ), carbohydrate oxidation rate (CHO), fat oxidation rate (FAT) and protein oxidation rate (PRO). Comparison between two groups were conducted by t test. Comparisons among groups were conducted by univariate variance analysis. The qualitative data were analyzed by χ2 test. Results REE in HC group, LC group, ALF group and SALF group were (6 180.05±1 434.68), (5 584.38±1 180.14), (7 107.01±1 641.22) and (6 530.31±1 306.92) kJ/d, respectively (F=3.557, P=0.018). REE/pREE (%) in four groups were (96.77±18.77)%, (88.80±17.71)%, (114.69±29.19)% and (112.48±17.33)%, respectively (F=7.389, P=0.000). RQ in four groups were 0.87±0.04, 0.83±0.06, 0.84±0.06 and 0.79±0.04, respectively (F=10.499, P=0.000). CHO in four groups were (51.53±13.00)%, (39.30±19.09)%, (41.15±20.35)% and (25.04±13.45)%, respectively (F=1.234, P=0.303). FAT in four groups were (37.00±13.99)%, (45.60±19.12)%, (43.85±21.01)%, and (59.39±15.94)%, respectively (F=2.125, P=0.103). PRO in four groups were (11.47±3.47)%, (15.10±4.83)%, (15.00±4.55)% and (15.57±6.88)%, respectively (F=2.338, P=0.080). The onset time of SALF group was (38.17±11.16) days, which was significantly longer than the ALF group of (8.85±3.21) days (t=-11.768, P=0.000). Conclusions REE and REE/pREE both increase in ALF and SALF patients, showing a hypermetabolic status. Nutrient metabolic disorder in SALF patients is more severe compared to ALF patients, characterized as a reduced RQ, decreased CHO and increased FAT, which may be associated with a longer onset time of disease. Key words: Liver failure; Resting energy expenditure; Respiratory quotient; Carbohydrate oxidation rate

Clinical significance of measuring resting energy expenditure for guiding an accurate nutritional support in elderly bedridden patients with nasal feeding

Objective To investigate the clinical significance of measuring resting energy expenditure (REE) for guiding an accurate nutritional support in elderly bedridden patients with nasal feeding. Methods The REE of 32 elderly bedridden patients with nasal feeding was assessed by using the Cosmed K4b2 portable telemetric gas analysis system. The waist-hip ratio, serum levels of albumin, transferrin, prealbumin and retinol-binding protein were determined to assess comprehensive nutrition status. The energy intakes were calculated, and the correlation of REE and the difference between the energy intakes and consumption with nutritional index were analyzed. Results The resting energy expendture was lower in the patients with waist-hip ratio≥0.95 than in patients with waist-hip ratio <0.95 (t=3.622, P<0.01). The waist-hip ratio was reduced and serum albumin and transferrin levels were decreased along with the increase of REE in elderly patients (r=-0.55, -0.36 and -0.593, respectively, P=0.001, 0.043, <0.001). The difference between the energy intake and expenditure was higher in patients with waist-hip ratio≥0.95 than those with waist-hip ratio<0.95 (t=5.643, P<0.001). Serum albumin, prealbumin, transferrin and retinol-binding protein levels were increased along with the increase of the difference between the energy intake and expenditure, which showed the positive correlations (r=0.525, 0.409, 0.624, 0.414, respectively, P=0.002, 0.02, <0.001, 0.019). Conclusions Precise determination of REE and energy intake guided by REE are the important guarantees for the reasonable nutrition support in the elderly. Key words: Energy metabolism; Intubation, nasogastric; Nutrition therapy

Influence factors and clinical application progress of resting energy expenditure

The resting energy expenditure(REE) is mainly used to maintain the normal function of body cells, organs and human awakening state, which is influenced by many factors, such as age, genders, fat distribution and endocrines.It is important by nutrition support according to the actual REE of individuals.The prediction equation only considers a single factor, so it couldn't estimate accurately the energy expenditure.Indirect calorimetry is a better way to know the actual REE and limited to be used in clinics.In this review, it will clarify the different energy needs in clinical populations with more focuses on the obese, premature infant and critical patients so that clinicians can facilitate the adequate nutrition support with minimum negative impacts from under-or overfeeding in these individuals. Key words: Energy expenditure; Indirect calorimetry; Nutritional support

Mild hypothermia impact on resting energy expenditure in patients with traumatic brain injury: a randomized controlled study

Objective To investigate the changes of metabolic rate in patients with severe traumatic brain injury under hypothermia state, and to assess the effect of hypothermia treatment with the metabolic rate in brain injury patients. Methods Patients with severe brain injury in ICU were enrolled in the study during January 2012 to January 2014. Eighty-three patients were randomly divided into mild hypothermia group (42 cases) and normal group (41 cases). The rectal temperature of mild hypothermia group was controlled in the range of 32 ℃ to 35 ℃ at the first 5 days; while the control group within the normal range (36.5-37.2 ℃). Both groups were measured the resting energy expenditure (REE, kJ/d) with a metabolic cart three times a day. Results The REE of the mild hypothermia group was significantly lower than that of the control group. The REE of the mild hypothermia group was at a low level at the first five days, which was about 60-70% of that of the normal group. The good recovery rate of the treatment group was significant higher than that of the control group [59.52%(25/42) vs. 34.15%(14/41), P 0.05). Conclusions In the range of 32 ℃ to 35 ℃, the REE was greatly reduced (nearly about 60-70% of the normal group), which might change the clinical outcomes in severe brain injury patients. Key words: Craniocerebral trauma; Hypothermia, induced; Energy metabolism; Clinical outcome

Impact of target energy intake on outcomes in septic patients : a prospective randomized controlled trial

To observe the impact of the diverse caloric energy intake on the outcomes and occurrence rate of complications in septic patients. A prospective single-blind randomized controlled trial was conducted. 158 cases of septic patients in intensive care unit (ICU) were enrolled and randomly assigned to three groups according to their different target value of nutrition: group A [measurements of resting energy expenditure ( MREE) <90% J , B ( MREE 90%-110%) and C ( MREE > 110%). The caloric intake, mechanical ventilation duration ( MVD),nosocomial infection rate, 28-day and 60-day mortality were analyzed. Daily energy intake in 7 days after ICU admission was as follows: the difference in target value of nutrition ( kJ/d: 7 075.0 ± 1 046.5, 5 667.8 ± 1 908.8,4 428.8 ± 1 377.8), calory intake ( k]/d: 4 671.6 ± 1 205.6, 5 655.3 ± 1 373.0, 6 053.0 ± 1 557.2), enteral nutrition value ( kJ/d: 2 051.1 ± 1 046.5, 3 980.9 ± 1 586.5, 5 337.1 ± 2 921.8) and average intake rate [ ( 66.0 ± 15.8 )% ,( 100.0 ± 5.7 )% , ( 134.0 ± 19.7)% J, and they were statistically significant difference among A, B, C groups (all P<0.05 ). The parenteral nutrition in group C were much higher than that in group A and group B ( kJ/d: 2 055.3 ± 273.4vs. 427.0 ± 273.4, 473.0 ± 332.0, both P<0.05 ). The calories provided by glucose and diprivan were similar among three groups. The MVD and ICU stay were shorter in group B than that in groups A and C [ MVD (days): 8.4 ± 6.3 vs.11.0 ± 8.2, 17.8 ± 13.0, P>0.05 and P<0.05; ICU stay (days): 11.0 ± 6.4 vs. 14.9 ± 9.6, 17.8 ± 13.0, respectively,P>0.05 and P<0.05]. The total hospital stay (days: 32.0 ± 22.5, 26.8 ± 7.0, 30.4 ± 21.4) and nosocomial infection rate [ 91.1% ( 51156) , 84.0% ( 42/50) , 90.4% ( 4 7/52) J were similar among A, B, C groups (all P>0.05). There was no difference in survival rate at 28 days among three groups as shown by the Kaplan-Meier survival curve ( F=3.145,P=0.076 ). The survival rate at 60 days showed a tendency of lowering in groups A and C, especially in group C (F=9.284, P=0.010). Both higher and lower caloric energy intake may be associated with an adverse impact, but appropriate caloric intake would improve the outcome and reduce the complication rate in septic patients.

Daily energy expenditure in the pouched mouse (Saccostomus campestris Peters 1896)

ABSTRACT Previous studies of the pouched mouse (Saccostomus campestris) have revealed that during reproduction there is no increase in food consumption, although resting energy demands, measured by respirometry, increase substantially. One explanation for this anomalous situation is that these mice may routinely use torpor to compensate their energy budgets. We measured the daily energy expenditure of eleven individual pouched mice over three consecutive days using the doubly-labelled water technique. The mice were housed in cages where they had free access to food and water, at an average temperature of 26.5 °C, and exposed to a natural photoperiod (February Pretoria). There was a large day-to-day variation in energy expenditure within each individual. The coefficient of variation in daily energy demand averaged 24.5%. By comparing the correlation of estimates for consecutive and nonconsecutive days we established that this variation was not a consequence of errors in the isotopic technique. The scaling ...

Determination of resting energy expenditure in critically ill children experiencing mechanical ventilation

Energy metabolism of critically ill children has its own characteristics, especially for those undergoing mechanical ventilation. We tried to assess the energy expenditure status and evaluate the use of predictive equations in such children. Moreover, the characteristics of the energy metabolism among various situation were explored. Fifty critically ill children undergoing mechanical ventilation were selected in this study. Data produced during the 24 hours of mechanical ventilation were collected for computation of severity of illness. Resting energy expenditure (REE) was determined at 24 hours after mechanical ventilation (MREE). Predictive resting energy expenditure (PREE) was calculated for each subject using age-appropriate equations (Schofield-HTWT, White). The study was approved by the hospital medical ethics committee and obtained parental written informed consent. The pediatric risk of mortality score 3 (PRISM3) and pediatric critical illness score (PCIS) were (7 ± 3) and (82 ± 4), respectively. MREE, Schofield-HTWT equation PREE and White equation PREE were (404.80 ± 178.28), (462.82 ± 160.38) and (427.97 ± 152.30) kcal/d, respectively; 70% were hypometabolic and 10% were hypermetabolic. MREE and PREE which were calculated using Schofield-HTWT equation and White equation, both were higher than MREE (P = 0.029). Correlation analysis was performed between PRISM3 and PCIS with MREE. There were no statistically significant correlation (P > 0.05). The hypometabolic response is apparent in critically ill children with mechanical ventilation; Schofield-HTWT equation and White equation could not predict energy requirements within acceptable clinical accuracy. In critically ill children undergoing mechanical ventilation, the energy expenditure is not correlated with the severity of illness.

Effect on Resting Energy Expenditure of Three Maintenance Diets

Patients who diet often regain all or part of lost weight, possibly because calorie restriction induces a decline in resting energy expenditure (REE). Whether the composition of the maintenance diet affects this decrease in REE was assessed in 21 overweight and obese adults …